title: Association between excessive daytime sleepiness and severe hypoglycemia in people with type 2 diabetes: the Edinburgh Type 2 Diabetes Study.
abstract: OBJECTIVE
  Sleep-disordered breathing and sleepiness cause metabolic, cognitive, and behavioral disturbance. Sleep-disordered breathing is common in type 2 diabetes, a condition that requires adherence to complex dietary, behavioral, and drug treatment regimens. Hypoglycemia is an important side effect of treatment, causing physical and psychological harm and limiting ability to achieve optimal glycemic control. We hypothesized that sleep disorder might increase the risk of hypoglycemia through effects on self-management and glucose regulation.
  
  
  METHODS
  People with type 2 diabetes (n = 898) completed questionnaires to assess sleep-disordered breathing, daytime sleepiness, and occurrence of severe hypoglycemia.
  
  
  RESULTS
  Subjects who scored highly on the Epworth Sleepiness Scale were significantly more likely to have suffered from severe hypoglycemia. This was a significant predictor of severe hypoglycemia in regression analysis including the variables age, sex, duration of diabetes, HbA1c, BMI, and treatment type.
  
  
  CONCLUSIONS
  Daytime sleepiness may be a novel risk factor for hypoglycemia.
authors.affiliation: Corresponding author: Rebecca M. Reynolds, r.reynolds@ed.ac.uk.
authors.forename: Berit
authors.initials: B
authors.lastname: Inkster
authors.forename: Renata L
authors.initials: RL
authors.lastname: Riha
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Van Look
authors.forename: Rachel
authors.initials: R
authors.lastname: Williamson
authors.forename: Stela
authors.initials: S
authors.lastname: McLachlan
authors.forename: Brian M
authors.initials: BM
authors.lastname: Frier
authors.forename: Mark W J
authors.initials: MW
authors.lastname: Strachan
authors.forename: Jackie F
authors.initials: JF
authors.lastname: Price
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Reynolds
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D006970:Disorders of Excessive Somnolence / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D001786:Blood Glucose